Nursing home closures and access to post‐acute care and long‐term care services in rural areas
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Published:2024-01-15
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Volume:
Page:
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ISSN:0890-765X
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Container-title:The Journal of Rural Health
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language:en
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Short-container-title:The Journal of Rural Health
Author:
Sharma Hari1ORCID,
Bin Abdul Baten Redwan2ORCID,
Ullrich Fred1ORCID,
MacKinney A. Clint1,
Mueller Keith J.1ORCID
Affiliation:
1. Department of Health Management and Policy University of Iowa Iowa City Iowa USA
2. Department of Public Health Sciences University of North Carolina at Charlotte Charlotte North Carolina USA
Abstract
AbstractPurposeNursing home closures have raised concerns about access to post‐acute care (PAC) and long‐term care (LTC) services. We estimate the additional distance rural residents had to travel to access PAC and LTC services because of nursing home closures.MethodsWe identify nursing home closures and the availability of PAC and LTC services in nursing homes, home health agencies, and hospitals with swing beds using the Medicare Provider of Services file (2008–2018). Using distances between ZIP codes, we summarize distances to the closest provider of PAC and LTC services for rural and urban ZIP codes with nursing home closures from 2008 to 2018 and no nursing homes in 2018.FindingsCompared to urban ZIP codes, rural ZIP codes experiencing nursing home closure had higher distances to the closest nursing home providing PAC (6.4 vs. 0.94 miles; p < 0.05) and LTC services (7.2 vs. 1.1 miles; p < 0.05), and these differences remain even after accounting for the availability of home health agencies and hospitals with swing beds. Distances to the closest providers with PAC and LTC services were even higher for rural ZIP codes with no nursing homes in 2018. About 6.1%–15.7% of rural ZIP codes with a nursing home closure or with no nursing homes had no PAC or LTC providers within 25 miles.ConclusionsNursing home closures increased distances to nursing homes, home health agencies, and hospitals with swing beds for rural residents. Access to PAC and LTC services is a concern, especially for rural areas with no nursing homes.
Funder
Federal Office of Rural Health Policy
Health Resources and Services Administration
U.S. Department of Health and Human Services
Subject
Public Health, Environmental and Occupational Health
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